"Florida House GOP Wants Poor People To Pay Three Times More For Health Care Than State Lawmakers Do"

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The GOP-controlled Florida state house on Friday passed a Medicaid “expansion” bill that would substantially burden the state’s budget by rejecting any federal funding. It would open up private insurance access to a very select pool of Florida’s low-income residents — but it could force these vulnerable Americans to forgo care, despite their new coverage, by giving them insufficient subsidies and making them choose between private high-deductible health plans (HDHPs) that also come with costly premiums.

Unlike its companion bill in the Senate — which has been endorsed by both Gov. Rick Scott (R) and the Obama Administration — the House’s bill would expand coverage to a mere one-tenth of the 1.1 million poor Floridians who would have gained access under a more expansive effort. That’s because the bill only addresses Americans living at or below the Federal Poverty Level (FPL), instead of Obamacare’s more ambitious limit.

Now that the bill has passed, a showdown between the House and Senate is likely. Although both bills would privatize Florida’s Medicaid program, the Senate’s version would insure all poor Floridians up to 138 percent FPL. The House version, on the other hand, will concentrate on extending insurance to poor single moms, poor working parents, and disabled adults by giving them a flat $2,000 per year subsidy — but would not extend coverage to poor working adults in general. Although Republicans insisted the pared down bill was necessary to contain rising health costs, critics argued that it is unfair to ask the poorest Americans to pay over three times the monthly premium as state workers and legislators, pointing out that there is bipartisan support for the Senate’s alternative bill:

The House plan would use $237 million in state funds to give recipients $2,000 a year to choose their own private insurance plans. The plans would require a $25 monthly premium and likely have high deductibles, which Democrats said many families would not be able to afford.

In contrast, House members covered by the state insurance plan spend $8 a month.

“There’s very little you can buy,” said Rep. Mia Jones, D-Jacksonville. “This population will not be able to take this product that has been crafted for them and not be able to do anything of value with it.”

House Democratic Leader Perry Thurston warned that members were missing a chance for bipartisanship, noting the Senate had already put aside their differences.

“We have a governor who has disagreement with the president of the United States but they came to a bipartisan resolution and put aside those differences,” Thurston said. “Why? Because of the importance of saving lives.”

As Jones points out, since this bill would provide Floirida’s uninsured with insurance that they still won’t be able to use, the $237 million price tag is largely a waste. The average annual deductible in HDHPs has been rising steadily as more employers rely on them, ranging anywhere from $1,100 for an individual to $2,500 for a family in 2012. By contrast, the average annual out-of-pocket health care costs for American households is expected to exceed $3,000 by 2014. So the $2,000 annual subsidy wouldn’t end up going very far at all. This would present a problem for any family trying to afford health coverage — but for the particularly vulnerable populations that the Florida House’s bill seeks to cover, it could be catastrophic. Low-income Americans have specialized health care needs that, in many cases, are simply not covered by cheaper private health plans.

Furthermore, an individual at 100 percent FPL only makes $11,000 per year. This bill would force them to pay $300 out of that salary towards premiums. By contrast, the average Florida lawmaker makes around $30,000 per year, and the chamber just voted to give state workers a raise while sealing in their $8 monthly premium. That means that Florida Republicans are essentially asking the state’s poorest residents to contribute nine times as much (relative to their income) in premiums than they themselves do.

The Obama Administration has already made clear that it is willing to pick up the full cost of the Senate bill’s expansion for three years, and 90 percent each year after that. But as the interal fight over Scott’s proposal shows, stubborn lawmakers in the Republican Party could end up derailing some GOP governors’ efforts to do the right thing for the medical and financial security of their most vulnerable.

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